MEDICARE: NESIVOS HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1588424840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NESIVOS HEALTH LLC

Provider Business Mailing Address
First Line	:	576 CENTRAL AVE STE 301
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-1943
Country	:	US
Telephone Number	:	917-697-4445
Fax Number	:

Provider Business Practice Location Address
First Line	:	1172 FISCHER BLVD
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-3096
Country	:	US
Telephone Number	:	973-678-5500
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MR. MOSHE ROSENBERG
Credential	:
Telephone Number	:	917-697-4445

Provider Enumeration Date	:	03/21/2024
Last Update Date	:	03/21/2024

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Directions to “NESIVOS HEALTH LLC ” Practice Location

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